25 BRIDGE STREET - CLAIM LOSS K]S INDEPENDENT
CLAIMS SERVICE, INC .
Service • Integrity • Experience
Notice of Casualty Loss to Building
Under Massachusetts General Laws, Chapter 139, Section 3B
July 13, 2021
Salem, MA Building Inspector
1 Salem Green
Salem, MA 01970
Salem,MA Board of Health
9 North Street
Salem, MA 01970
Salem, MA Fire Department
48 Lafayette Street
Salem, MA 01970
INSURED: Evelyn Palardy
ADDRESS: 25 Bridge St, Salem,MA 01970-4106
LOCATION OF LOSS: 25 Bridge St, Salem, MA 01970-4106, US
COMPANY: MAPFRE Insurance
POLICY#: 4690094914
CLAIM#: 21-88848
DATE OF LOSS: 07/09/2021
TYPE OF LOSS: Wind
Dear Sir or Madam:
Independent Claims Service is the insurance adjusting firm hired by the above referenced client to handle the
captioned loss on behalf of their insured.
A claim has been made involving loss, damage, or destruction of the above-captioned property which may
either exceed $1,000.00 or cause Massachusetts General Laws, Chapter 143, Section 6 to be applicable. If
notice under Massachusetts General Laws, Chapter 139, Section 3B is appropriate, please bring it to our
attention, and include a reference of the captioned insured: Location, policy number, and/or date of loss.
Sincerely,
INDEPENDENT CLAIMS SERVICE, INC.
JUL 19 P,0:53
JUL
22 Water Street • Westborough,MA 01 581 • 508.366.8535 • FAX 508.366.091 7 • www.icsclaims.com